Te Rangihaeata Oranga Trust. Report to the Ministry of Health

Transcription

1 Te Rangihaeata Oranga Trust Report to the Ministry of Health National Maori Problem Gambling Hui (Ngati Kahungunu 6-8 October 2009) 1

2 Contents Page Contents... 2 Executive Summary... 3 Overview: Four Pathways to Whanau ora... 5 Introduction... 5 Section One: Key Themes: Key Theme One: Examining the Successful Models within PGS... 5 Key Theme Two and Three: Adding Value and Strengthening Cohesion... 6 Key Theme Four and Five: Exploring Collective Solutions and Validating Wisdom with Tikanga Key Theme Six: Identifying the Outcomes of Whanau Ora Section Two: Evaluation of the Conference Section Three: Future Planning Section Four: Summary of Outcomes and Recommendations Appendices

3 Executive Summary In May 2009, a meeting was held in Auckland with Maori Providers of Problem Gambling Services (PGS), Key Stakeholders and the Ministry of Health to discuss the upcoming National Maori Provider hui for Ministry of Health contracted providers of problem gambling services to identify the main themes for the conference. The over-arching kaupapa was on the four pathways of Whanau Ora outlined within He Korowai Oranga National Maori Health Strategy produced by the Ministry of Health (2002) which included: 1. Development of whanau, Hapu, Iwi and Maori Communities; 2. Maori Participation in the health and disability sector; 3. Effective health and disability services; and, 4. Working across sectors. There was an agreement from the people attending this hui to ensure the upcoming conference and workshop presentations would focus on the following areas: Examine the models already used successfully within the Problem Gambling Sector (PGS). Adding value to what Maori providers are doing in the PGS. The preference is to have quality over quantity. Developing a sense of cohesion and outcomes hoped to be achieved in the PGS. That every participant attending the conference is encouraged to have input and to move forward as one waka. The emphasis is on discovering who we are, our commonalities and collective solutions. Strengthening Whanau Ora particularly within the current economic crisis and to provide solutions for how to work collaboratively together in unity, wisdom and tikanga. Ensuring there is a Rangatahi perspective with an emphasis on empowerment models. Agreement was reached that the National Maori Problem Gambling Hui would be held in Napier (between the 6 th 8 th October 2009) and hosted by Te Rangihaeata Oranga Trust. This report has been prepared for the Ministry of Health to summarise the highlights, outcomes achieved and recommendation from the conference. These are outlined below: Theme One: Successful Models within the PGS Maori Providers within the PGS have developed creative and innovative models that are effectively responding to the needs of Maori whanau and to enhancing and strengthening the resilience of whanau ora. A key element of each model presented was the importance placed 3

4 on Maori cultural values, tikanga, strengthening relationships, connections and sense of belonging. The key recommendation is to continue showcasing and celebrating the successful interventions and models by sharing and exchanging knowledge with other Maori Providers within the PGS (ie, through hui, newsletter, web sites, workforce development programmes and other mediums). Theme Two and Three: Adding Value and Strengthening Cohesion These themes were thoroughly explored in a variety of contexts including: workforce development, MOH strategic plan, audit process, rangatahi services, and other areas. There was a particular emphasis placed on ensuring rangatahi needs were being met, to encourage their active participation in decision making and to grow their leadership potential. There were contractual constraints impacting on the ability and capacity of Maori providers within the PGS to respond effectively in adding value and strengthening cohesion. The key recommendations are to strengthen Maori workforce development and capacity; to ensure by Maori, for Maori service provision in PG; that Maori targeted putea is not captured by the mainstream PGS; and, that the MOH are committed to resources and funding within the PGS to ensure the sustainability of Maori Provider service provision within the PGS. Theme Four and Five: Collective Solutions and Validating Wisdom within Tikanga There was tremendous commitment and dedication expressed by participants to work more collaboratively together. The importance of cultural values (ie, manaakitanga, whakawhanaungatanga, wairuatanga and kotahitanga) was highlighted throughout the conference and affirmed the potential strength of collective wisdom available within the Maori Provider workforce of PG. The key recommendation is that Maori Providers within the PGS are on the same waka rowing in unity and purpose. Theme Six: Identifying the Outcomes of Whanau ora Participants acknowledged there was a diverse understanding and meaning given to the concept of whanau ora. There was much discussion held throughout the conference on the many challenges and barriers confronting whanau. The issues were multi-faceted, complex and often inter-generational. The solutions would require creative, innovative and alternative approaches to meet the needs of tamaritki, rangatahi, pakeke, Kaumatua to achieve the desired outcomes of whanau ora. The key recommendation is that the MOH is committed to addressing the challenges and achieving the four pathways of whanau ora expressed within He Korowai Oranga. 4

5 Overview: Four Pathways to Whanau Ora Introduction The overarching aim of the conference was the four pathways to whanau ora and is strongly depicted in the Logo designed for the conference. The key themes of the conference focussed on: examining the successful models within the PGS, adding value, strengthening cohesion, exploring collective solutions, validating wisdom within tikanga and identifying the outcomes of whanau ora. This report provides an overview of the National Problem Gambling Conference. In the first section is a discussion on the key five themes to emerge from the conference. The second section presents a summary of the evaluations and feedback from Participants. The third section outlines the upcoming International Indigenous Symposium and the next national problem gambling conference planned for The final section provides a summary on the outcomes achieved and key recommendations. Section One: Key Themes This section will provide an overview of the workshop presentations on the key themes and achievement of the desired outcomes for the conference (see Appendix One for the programme content). Key Theme One: Examining the Successful Models within PGS There was a wide range of presentations on successful models operating within the PGS such as the three groups briefly described below: Te Runanga O Toa Rangatira: provides a range of whanau ora services with a particular focus on growing rangatahi leadership. The emphasis was on encouraging rangatahi to feel valued and of worth, learning their whakapapa and other cultural values. The Trust is currently working towards developing and establishing a whare for Rangatahi who are driving the project, participating in all aspects of decision making. Other initiatives include: planting a mara, encouraging healthy lifestyle changes through exercise and other recreational activities. Nga Manga Puriri: are currently consulting widely with their communities to develop initiatives to address social risk factors and other health issues. The Trust has established mara to plant the seeds, grow the future vegetables that can be shared with whanau and to strengthen the links between the environment and health of people. Building resilience and healthy communities. Te Roopu Tautoko Ki Te Tonga from Te Waipounamu utilise Waiata, performing arts and theatre to effectively promote healthy lifestyle change free of PG. There is a 5

6 particular emphasis on engaging rangatahi in their presentations promoting the message of being free of PG to a wide cross section of the community (ie, kohanga, primary and secondary schools etc). Key Themes Two and Three: Adding value and Strengthening Cohesion Participants discussed these themes throughout the conference in a variety of contexts outlined below: Maori Workforce Development Adding value and strengthening cohesion within the PGS workforce was of vital importance. Hapai Te Ora Tapui was in a strong position to ensure whanau ora services could look after whanau how they wanted to be looked after. This Organisation is a lead Provider in partnership with Problem Gambling Foundation and Niu Development Incorporated to develop workforce programmes for the PGS. Their deliverables are to undertake a needs assessment, develop PG programmes, develop e-learning hub and to develop a draft training manual for the PGS. A wide range of workforce development needs were identified by participants and are listed below: - Tika, pono, aroha walk your talk. - Where there is no vision, the people will perish. - Transforming whanau, tinorangatiratanga applied. - Relevance/ make it fit into the contract and having to compromise on cultural values. - Study the needs, planning. - Training on how to balance the tension between meeting MOH contractual needs and needs of whanau. - Training on structure around what is working well and not. - No database or template of additional work done by organisations included in monitoring reports to MOH. - Only narratives given of the highlights, trends and issues etc but this does not accurately reflect all the additional work done by kaimahi. - Sometimes we just got to get out there and do the work- no time for training! - There needs to be full on consultation process with meaningful sharing amongst providers, mainstream, agencies. - Application of all the tangas holistic kaupapa Maori. - Lack of understanding on contractual obligations. - Developing alternative revenue streams to strengthen the sustainability of Maori Organisations. - Tensions with working in PG sector alongside other contracts that need to be met only part time on the kaupapa and does not allow for sufficient time and energy to focus and specialise on PG specifically so there are missed opportunities there. 6

7 - Workforce development needs to ensure there is cultural measures for assessment/auditing tools used to enhance and support organisations against cultural indicators and not just western linear approaches to service delivery (ie, western models of counselling can be enhanced by the integration of Maori models and approaches). - Training on Kaupapa Maori theories and its application within both health promotion and clinical interventions of service provision. - Specialist target group approaches are needed to reach Pakeke which will be different to Rangatahi and Kaumatua differences include: peer on peer, language, resources, space and time, music, Te Reo etc more training to support the workforce to understand who, how and what approaches need to be incorporated to ensure the best quality services available and more importantly, are accessed by whanau. - Training on developing strategies in planning and target special groups. - How to effectively build alliances at local, regional and national levels to ensure Organisations are sustainable. - Sharing knowledge, exchanging skill base, resources and forming collaborations around specific projects all needed for kai mahi. - Training on how to work across sectors and linking PG to other health, socioeconomic factors to provide a holistic approach. - Development of quality tools that ensure cultural competencies are measured. - Development of innovative and creative programmes within PG health promotion and thinking outside the box often on limited resources need to show case the successful interventions and share these models with other Organisations what is working well and how can we add value to these effective models? The MOH Six-Year Strategic Plan Eight Maori Providers of PGS responded to the consultation document on Preventing and Minimising Gambling Harm , seeking to add value and strengthen cohesion. There was a call for the MOH to ensure stronger links with He Korowai Oranga and to strengthen wrapping services around whanau ora. The MOH had also made some procedural and structural changes that had been incorporated into the revised document now posted on the web. Audit of the PGS All of the providers in the PGS had recently completed their three yearly audits. The MOH had ensured more consistency in the audit process by engaging one independent auditor. The focus was on ensuring strong relevant skills, public health, clinical and cultural competency. Most of the participants acknowledged they had gained added value from the audit process which had strengthened cohesion within the Organisation (ie, policies and procedures). 7

8 Maori Providers of PGS expressed concern at the focus on due diligence or the emphasis on legalistic compliance requirements expected by MOH instead of more attention on quality and cultural competencies. There was also concern expressed on the uncertainty of contracts and to the long term sustainability of the PGS given the recent restructuring and contracts being cut within the PGS. There was a perception the audits were an excuse for cutting contracts (as evidenced in Te Waipounamu) instead of benefit for Maori Providers. Another concern was the lack of recognition within the audit process on the holistic services provided by Maori Providers which was often ignored or marginalised. Rangatahi PG Services The presentation from Toiora highlighted the importance of adding value and cohesion for encouraging more participation of rangatahi to access PG services. Participants were concerned there was not a strong rangatahi presence at the conference. It was also acknowledged that,...[rangatahi] expressing ourselves, generational communication, language, arts etc...there is a changing world that needs to relate to rangatahi needs. Some important questions were raised on how to effectively engage with rangatahi and to strengthen their leadership capability:..,rangatahi are our Pakeke of tomorrow so how do we apprentice and prepare them in their leadership roles with PG specifically?...are their rangatahi plans as part of regional and national health promotion plans built in?...we must not marginalise the rangatahi workforce development by concentrating on one end of the continuum (ie, western clinical, public health) to the exclusion of Te Ao Maori Cultural values. Rangatahi of this generation are especially affected by electronic gambling (ie, Holdem- Texas Poker) where they are even more isolated and cut off from whanau and community. There was a general consensus from the participants that rangatahi had the capacity to revive and energise whanau and that their unique perspectives and views would add value and needed to be nurtured and enhanced. PGS Contractual Constraints Maori providers expressed a range of issues impacting on their capacity to add value and to strengthen cohesion within their Organisations and included: Isolation of PG services made more vulnerable when contracts were discontinued and the uncertainty of whether these PG services for Maori would be delivered by another 8

9 Maori Provider service. There was concern that Maori whanau were not likely to access mainstream PG services. Maori Providers of PG services contracted to provide either clinical (personal) services (ie short term intervention) or public health promotion services and the fragmentation this causes for referring whanau on. The uncertainty of short term contract agreements with MOH that is particularly difficult for the more vulnerable Organisations in the long term sustainable development of their services. The tensions caused by meeting contractual agreements which do not take into account the additional holistic approaches operating outside of the contract to meet the expectations of whanau and community obligations. The short term clinical interventions are not taking into account the multiple issues facing whanau (ie socio-political realities) which is difficult to separate in seeking to provide a more holistic wrap around service to strengthen whanau ora. Whanau living in isolated rural communities do not have access to PG services. Mainstream PG services are competing with Kaupapa Maori Providers services for the same whanau causing duplication, - gate-keeping and mistrust. Resources need to be developed with special needs (ie Kapo Maori provided with resources in Braille). Whakatau Mai Ra The launching of the research project on the Impact of PG for Maori Communities was a National Maori Collaborative Approach led by the Research and Development Unit of Te Rnanga O Kirikiriroa (see Appendix Two). This important research project provided an indepth study and understanding of PG on Maori Communities within the context of an holistic Maori world view that involved recording stories of gambling and providing recommendations for policy and advice to the Ministry of Health adding value to evidence based research on PG. Six Maori Providers of PG services participated in the study. National Coordination Services (NCS) This two year contract is held by the Salvation Army and is due to end in June The service has added value and strengthened cohesion within the PGS providing a conduit of information and facilitating a process for voicing the concerns of the PGS to the MOH. NCS provides a range of support services and plan to visit all the Providers of PGS by the end of this year. Te Herenga Waka The participants acknowledged the vital role and function of this Organisation and their contribution in adding value and strengthening cohesion within the kaupapa of PG. In 9

10 recognition the Ministry of Health has sought Te Herenga Waka s views regarding the draft Strategic Plan for Preventing and Minimising Gambling Harm Key Themes Four and Five: Exploring Collective Solutions and Validating Wisdom within Tikanga Building Collaborations There was a strong response from participants to build collaborations within the PGS: [The need to]...build strong relationships with other services (ie key collaborations, referrals, strong tautoko, ongoing support and follow up with whanau, referral services etc. A collective voice for whanau to control their lives...wellbeing directly related to how much control we have over our own lives...we need to get on the same waka and get involved. The collective korero that embraces everyone within Te Waipounamu...always going to be controversy about change and need the courage to face this (ie, MOH changes to integrate PHOs and the implementation of EQI?). A major issue with the public health model [is that it] tends to isolate the problem, contain it and is a fragmented approach working separately instead of taking a more holistic approach within whanau ora. Maori Providers of PG services recognised the need to strengthen alliances within the Maori workforce to safeguard Maori putea targeted for Maori whanau that was being delivered by mainstream PG services who were not necessarily the most culturally appropriate or culturally competent Organisation to meet the needs of Maori whanau. One particular participant encouraged Maori Providers to change their mind set: We must change our mind set from viewing Kaupapa Maori services as the alternative service and consider ourselves mainstream! There is a huge Maori workforce now in Maori health provision and we are a major force in the health sector with Hapu and Iwi delivered health services so we are main stream! Participants also expressed the importance of working across the other sectors and the need to link better (ie, health, education, social, probation services etc). Whanau often came with a range of needs that would have benefited from the notion of wrap around services where agencies would provide a more holistic service to whanau and reduce fragmentation by ensuring better referrals and follow up services to whanau. 10

11 Strengthening Cultural Values/ Tikanga There was a need for Maori Providers to:...identify their shared priorities and shared vision for a collective approach/voice to address the barriers of access to PG services. Maori had the capacity to access their creativity through Te Ao Maori - Maori ways, values, norms and processes that acknowledged Maori worldviews and perceptions. Kaupapa Maori approach is holistic where everything is related and there is an interactive synergy. Kaupapa Maori approaches work holistically within inter-generational whanau issues to dwell in the positive for change/resilience The power of PONO and not suppressing wahine, tane, Maori pono. Collect Maori stories on their history of problem gambling or who have been affected by PG. The Kaumatua stream discussed the importance of whanau ora in the context of the Whare Tapa Wha model where each element of wairua, whanau, hinengaro and tinana was explored and is outlined below: Wairua: unseen/can t separate feelings from your heart; intuition or puku; ngahere appreciating the creation/contact with the creator/spiritual contact with each other; Connection with Atua, whenua and tangata; energy with one self; spirit of the divine given to each one of us and which way we protect that wairua to all creatures, wild life; emanating that energy to that other living entity; giving out the energy that we have to care for; wairua tapu becoming a child of God traversed this way of life to wairua Maori (ie, tika, pono, aroha.). Tinana: physical, arms, legs; performs the feelings; mobility; exercising to give you peace of mind; Taputapu he momo ahua tangata. Hinengaro: emotional affirmations; self-care; building the relationships. Whanau: whanau- wairua connects to tinana of the whole whanau ora; whanau to encourage and awhi each other; wairua tapu part of this; basics of empowering ourselves. 11

12 The Kaumatua identified a number of issues impacting on whanau ora that included: The separation of wairua changing the way these four parts relate to each other; falling into the trap of over-indulging (in addictions?); hard to accept what Kaumatua are trying to teach them; have to know, see,touch experience for them to ensure their future; disruption to whanau and how do we tell whanau?...tracing the beginnings and infiltration of other foreign bodies within the purity of our own physical body. The epidemic flu killed many of our men returning from WW1 because there was no resistance or immunity to this disease. Kaumatua can raise the level of knowledge/ driving the way forward; can look at what the mamai is. Kapahaka strengthening their cultural links and sense of belonging and identity the most important element...how do we meet the challenges of our people...wairua within the triangle of pono, aroha, tika. Kaumatua challenging each other and to stop our kids going into prison...challenging Kaumatua sitting on the paeapae or in leadership positions that have a history of violence (or other issues that have violated the tapu of whanau). Learning from the experiences of Auckland and the Super Cities issue and the impact this new structure will have for whanau, Hapu and Iwi...this model is likely to be implemented through-out the country so Maori need to be aware. Key Theme Six: Identifying the Outcomes of Whanau Ora Concept and Resilience The concept of whanau ora represents a wide range of perspectives concerned with holistic health and social development, spiritual wellbeing, cultural identity, sense of connection and belonging to the land and people, physical health and other factors. The Panel Presentation held on the Four Pathways discussed the implications of whanau ora for building resilience. There was the notion of rebounding back to a previous experience location - where there was the capacity for rebuilding lifestyle and to, taking a journey to a better point, known and comfortable. Resilience was through cultural determinants including cultural values, identity, Maori language, knowledge and customs. The focus needed to be on enhancing resilience instead of on disparities and inequalities which did little to mobilise and motivate people to change the resilience lens you choose to wear will determine what impact this will have on whanau ora. 12

13 There are many socio-political circumstances and challenges facing whanau in the modern world which continue to have implications on whanau ora. The open forum discussions during the conference raised many issues and barriers impacting on whanau ora which all require creative solutions and the collective strength of the entire PG Maori workforce to strengthen the outcomes of whanau ora - of restoring the mana and tapu of Atua, whenua and tangata. Section Two: Evaluation of the Conference This section provides a summary on the feedback and evaluations completed by participants. A total of 80 participants registered for the conference (see Appendix Three for registration schedule). Thirty one evaluation forms were completed on the final day of the conference with an additional number of people sending feedback through (see Appendix Four for a copy of the evaluation form and summary of responses). The highlights for participants were the whanaungatanga, manaakitanga, wairuatanga warmth, sharing and care experienced from other participants and the host group. Overall, the responses were very positive and some of the comments expressed were: - Intervention presentations and ideas, Whakawhanaungatanga, Waiata, Kaupapa focussed korero specifically from rangatahi, whanau ora korero. - The manaakitanga...feeling of the warmth and love of Te Rangihaeata Oranga. - The facilitator Terry Huriwai and the manaaki from Te Rangihaeata Oranga. - Workshops/contacts/values, sticking to the timeframes at all times, the kai. - Innovation of learning and application from other kai mahi. - Kotahitanga all the groups coming together for the good of the whole. - The way we can speak openly, and honestly about important take and keep it respectful. - Korero about hapu strategies to address PG within their whanau. The responses for areas least enjoyed were mostly focussed on the workshop presentations where some presenters needed to stay focussed on their kaupapa. There was a suggestion made that Maori providers might benefit from some workforce development training in power point presentations. The responses included: - Coming and going of people impacting on valuable korero is diminished by people infrequent attendance. - That everyone chose to stay at a motel rather than enjoy the whanaungatanga of the marae. - Having to go on diet when i get back. - Too many presentations and listening too much, would appreciate more presentations in a workshop style. 13

14 - Some of the speeches in the launch were too long although some of the pearls to emerge were worth it. - Days were too long sitting on uncomfortable seats. Many of the participants found the workshop presentations very useful. Some of the comments expressed were: - The ability of sharing the impacts of whanau ora. - Wednesday Kaumatua stream this reaffirmed the tikanga of being Maori working in the field of problem gambling toward achievement of whanau ora. - Enjoyed all the presentations, very touched by Missy s story, the Taitokerau groups, Dianne Richards. - Each session was a learning, challenges and solutions. - Workforce development and the meaning of collaboration. - Personal sharing of gambling history. - The wider insight to the cries of the heart past, present, re family concerns, tragedy. - Reaffirm that we are trying to maintain our kaupapa in our mahi. - Knowing what other people are doing...all orgs are relevant, it is important to have insight of what orgs work and vision are and who are effective Responses from Participants on the areas found least useful were: - NCS seemed to assume no support for Te Herenga Waka as an indication that it needs replacing... sometimes we have enough to do and worry about that having to pick teams or sides is really more of a disruption than anything. - The ones that spoke went on too much. - Sitting and listening too long. Participants commented on the four pathway themes and how their Organisation is making a contribution towards improving whanau ora. The responses included: - Development of whanau, hapu, iwi and Maori communities; Maori participation in the gambling sector requires active participation from all sectors as well. - Confirmation we work all four pathways and are passionate about the work. - Whanau ora requires time and relationship building, not all whanau ora concepts fits into contracts...our organisations is addressing and moving towards whanau ora are slowly but surely. - Mainstream organisations continue to struggle with the principles of Te Tiriti o Waitangi. - Important to develop tamariki and rangatahi, and to grow leaders, continue to strengthen and develop our whanau, hapu and iwi. - Need to address the korowai of kaumatua as the essential component in our services. 14

15 Participants were asked to comment on how Collaborative relationships will be formed with other Organisations to progress whanau ora in the future. There was concern expressed for rangatahi and the need to ensure more effective and relevant services were developed. Many of the participants strongly felt that Maori Providers could provide a more effective and highly responsive PG services to Maori and that the MOH needed to ensure the putea for Maori whanau was not captured by mainstream services. Other responses were: - PGS Oasis general services to adopt and not think that s our job to do it. - Needs to be solutions based focus, focussed collaborative approaches, disseminate learnings from these hui for instance. - Maori providers are very capable of working collectively and to accessing the wellspring of wisdom and knowledge from each other. The issue is with mainstream PG services who continue to gate keep and compete for the same putea that should be delivered by Maori, for Maori services. Participants were asked to comment on how this conference could have been improved and any suggestions for the next hui. The responses included: - Manaaki, tautoko, korero, kai, kaumatua, whakaoriori and waiata big ticks - Take it Taranaki we should pass the rakau as part of the closing ceremony - Continue to be creative, hui well organised. - Te Rangihaeata did a great job and Terry. - Karakia to ensure Napier/Taupo road is open. - Encourage the speakers to use the microphone. - Some of the Presenters need earlier preparation. - Message of enlightenment through song and dance (remains concreted in Hinengaro). - The standards and quality of organising this conference needs to be maintained - Add more time for presentations. - White board where kaimahi questions can be answered during the hui and what they would like to take away from the hui, and time slot at end to address these and other issues, invite people from Minister of Maori Affairs, Education, Police, Housing, Justice, local Govt, Consumers. - Get more funding earlier for hui. - Marae based hui and initiating a rangatahi forum. - Maybe some breakout opportunities. - Have a youth stream where we can discuss the same things but in our way the way we learn best to get the most out of the hui. Most of the participants gave an over-all ranking of four or five te mea nui rawa atu! 15

16 Section Three: Future Planning This section briefly outlines the upcoming International Indigenous Problem Gambling Symposium planned in 2010 and an overview on the discussion held for another three day national problem gambling hui. International Indigenous PG Symposium. The Symposium will be held in Rotorua Nga Pae o Te Maramatanga is one of the main sponsors which has influenced the key themes of the Symposium needing to reflect healthy communities, healthy environments, transformation of Society and new frontiers. There has been confirmation from three of the key note speakers: Wanda Brown (from Australia), Moana Jackson and Chief Terence Nelson (from Canada). Participants were encouraged to support this symposium through: manaakitanga, kai mahi, tautoko, hoea te waka. The potential Outcomes to be achieved are, show case interventions, access to national and international networks, workforce development, increased awareness of PG, addressing issues of PG. National Problem Gambling Conference The high standards established by Te Rangihaeata in hosting this year s national problem gambling conferences had set precedence. There was unanimous support from the participants to hold another three day hui instead of a two day PG hui (similar to the hui held in 2008). NCS had funding to support a two day hui which was available until the end of June 2010 with no guarantee that the funds would be available after this date. It was important to stress that the responsibility would be on the Organising host to secure funding for the shortfall. Dennis McLeod from Toiora volunteered to host a three day hui in Taranaki and was fully supported by participants. There were suggestions provided by various participants on possible funding sources and other tips such as securing funding early to avoid some of the issues encountered by Te Rangihaeata Oranga. Section Four: Summary of Outcomes and Recommendations This final section provides a summary of the outcomes and key recommendations to emerge from the conference. The conference set out to address the key themes identified by the hui held in May ealier this year and included: examining the successful models within the PGS, adding value, strengthening cohesion, exploring collective solutions, validating wisdom within tikanga and identifying the outcomes of whanau ora. The key points and recommendations to emerge from each theme are outlined below: 16

17 Theme One: Successful Models within the PGS Maori Providers within the PGS have developed creative and innovative models that are effectively responding to the needs of Maori whanau and to enhancing and strengthening the resilience of whanau ora. A key element of each model presented was the importance placed on Maori cultural values, tikanga, strengthening relationships, connections and sense of belonging. The key recommendations are to continue showcasing and celebrating the successful interventions and models by sharing and exchanging knowledge with other Maori Providers within the PGS (ie, through hui, newsletter, web sites, workforce development programmes and other mediums). Theme Two and Three: Adding Value and Strengthening Cohesion These themes were thoroughly explored in a variety of contexts including: workforce development, MOH strategic plan, audit process, rangatahi services, and other areas. There was a particular emphasis placed on ensuring rangatahi needs were being met, to encourage their active participation in decision making and to grow their leadership potential. There were also concerns raised on contractual constraints impacting on the ability and capacity of Maori providers within the PGS to respond effectively in adding value and strengthening cohesion. The key recommendations are to strengthen Maori workforce development and capacity; to ensure by Maori, for Maori service provision in PG; that Maori targeted putea is not captured by the mainstream PGS; and, that the MOH are committed to resources and funding within the PGS to ensure the sustainability of Maori Provider service provision within the PGS. Theme Four and Five: Collective Solutions and Validating Wisdom within Tikanga There was tremendous commitment and dedication expressed by participants to work more collaboratively together. The importance of cultural values (ie, manaakitanga, whakawhanaungatanga, wairuatanga and kotahitanga) was highlighted throughout the conference and affirmed the potential strength of collective wisdom available within the Maori Provider workforce of PG. The key recommendation is that Maori Providers within the PGS are on the same waka rowing in unity and purpose. Theme Six: Identifying the Outcomes of Whanau ora Participants acknowledged there was a diverse understanding and meaning given to the concept of whanau ora. There was much discussion held throughout the conference on the many challenges and barriers confronting whanau. The issues were multi-faceted, complex and often inter-generational. The solutions would require creative, innovative and alternative 17

18 approaches to meet the needs of tamaritki, rangatahi, pakeke, Kaumatua to achieve the desired outcomes of whanau ora. The key recommendation is that the MOH is committed to addressing the challenges and achieving the four pathways of whanau ora expressed within He Korowai Oranga. 18

19 APPENDICES One: Two: Three: Four: Conference Programme Whakatau Mai Ra Registration Schedule Evaluation Form and Summary of Responses 19